A 2010 article from the Journal of Neurology Neurosurgery and Psychiatry broke down the evidence of what other elements can help distinguish PNES from epileptic seizures.

Duration over 2 minutes suggests PNES, but we’ve all seen epileptic seizures last for a long time, status, and some PNES can be super short

Happens in sleep. Evidence suggests that if the event happens in sleep, that is probably episode. PNES episodes happen when awake

Fluctuating course such as a pause in the rhythmic movement, epileptic seizures usually don’t pause and then restart, a pause favors PNES

Flailing. You’d think the flailing patient has PNES for sure because epilepsy doesn’t flail, but it does! Flailing is much more common in PNES, but not so much so that it’s a clear distinguishing factor

Urinary incontinence, more common in epilepsy, but does happen in PNES.

Post-ictal recovery period. Surely, this is the sine qua non of epilepsy. It is way-way more common following generalized epileptic seizures but happens in around 15% of PNES.

The stertorousbreathing (noisy, labored) that we see after generalized tonic-clonic epileptic seizures suggests epilepsy and is not a characteristic of PNES